[The balloon dilatation of esophageal stenoses]. / Dilatarea cu balon a stenozelor esofagiene.

A number of 55 balloon dilatations were performed on 23 patients with oesophageal stenoses of various aetiologies. Among these, 22 displayed benign stenoses and only 1 case had a malignant aetiology. The number of dilatations per patient varied from 1 to 3. In the evaluation of the results, only the clinical criterion was taken into account, the radiological examination and the oesophageal passage scintigram being inconclusive in the respect. The balloon dilatation was successfully performed in 96% of patients. In the long-term follow-up, 82.4% of the patients with benign stenoses benefitted from this therapeutic procedure. In some patients it was necessary to repeat dilatation. The asymptomatic free interval was on the average of 11.5 months. It is concluded that the balloon dilatation is a simple, safe and readily applicable therapeutic method, that may be successfully used in the treatment of oesophageal stenoses of various aetiologies, allowing in most cases to avoid the surgical intervention.

[Is an esophageal transit scintigram necessary in patients with gastroesophageal reflux?]. / Este necesara scintigrama de tranzit esofagian la pacientii cu boala de reflux gastroesofagian (BRGE)?

Efficient esophageal clearance has an important defence role in the pathogenesis of the gastroesophageal reflux disease (GERD). Many GERD patients have esophageal disturbances associated with or secondary to reflux, producing delayed clearance. This delay exposes the esophageal mucosa to the reflux acid content. To determine esophageal transit we scanned the esophageal transit of a 15 ml bolus containing colloidal 300/cCi 99m Tc. The esophageal transit was calculated in seconds according to formula E.T. = T 1/2 x 5. The study included 74 GERD patients. The following investigations were carried out in all the cases: esophageal X-ray, GER scintigram, endoscopy, esophageal biopsy, Bernstein test and esophageal transit scintigram. Endoscopy revealed lesions of the esophagus (of 1st, 2nd and 3rd degree) in 39 patients, Barrett syndrome in 8 cases and normal in 27. Esophageal transit scanning was normal in 18 cases (24%), and prolonged in 56 cases (76%). Only 7 (39%) of the 18 patients with a normal transit presented lesions of the mucosa, the latter being more frequent in patients with a prolonged transit, i.e. 40 of 56 patients (71.5%). The mean value of the transit in different degrees of esophagitis (I, II, III) and Barrett syndrome were: 12.73 +/- 5.36; 13.30 +/- 7.90; 10.35 +/- 5.78; 17.25 +/- 11.17. In conclusion esophageal transit scanning is a useful test in GERD patients as it has a prognostic value. A prolonged esophageal transit is frequently associated with lesions, the more severe the slower is the transit. Moreover the test may indicate certain drugs acting upon the esophageal motor disturbances.

Modulation of natural killer cell activity by serum from cancer patients: preliminary results of a study of patients with colorectal adenocarcinoma or other types of cancer.

As previously reported for natural killer (NK) cells of normal individuals, prior incubation of peripheral blood lymphocytes from cancer patients with human normal serum or monomeric immunoglobulin G reduced their subsequent capacity to kill K562 target cells in a 4-h 51Cr release assay. The NK activity of such treated effector cells was significantly inhibited only by 58% of sera from patients with colorectal adenocarcinoma (21 of 36 cases) and by 67% of sera from patients with other lymphoid or nonlymphoid solid tumors (22 of 33 cases). The cytotoxic activity of cells previously incubated with eight noninhibitory sera was even augmented relative to medium-treated peripheral blood lymphocytes (control). The 26 untreated cancer sera which did not inhibit significantly the NK activity (I-) always developed significant inhibitory capacity upon heating at 56 degrees C for 30 min (delta+). An additional seven (21%) patients with colorectal carcinoma and four (27%) patients with other cancers were identified as having type II NK regulation, defined as sera with untreated inhibitory capacity (I+) but with appreciably more inhibition after heating (delta+). The sera of the last group of patients with colorectal adenocarcinoma (14 of 36 cases) defined as having type III NK regulation were not different from control sera isolated from normal individuals (I+ delta-) except that they induced an inhibition greater than that caused by normal sera. The modulatory characteristics of sera from the first two categories of patients appear to be cancer associated, since the patterns I- delta+ or I+ delta+ were observed with sera from only one of 30 patients with benign digestive diseases and two of 100 apparently healthy individuals. Preliminary results of longitudinal investigations of patients with colorectal adenocarcinoma revealed also that these patterns disappeared several months after resection of their tumor in all five tested patients, whereas the type III NK regulation found in patients with poor prognostic factors was unchanged after surgery in the other five of six patients. The three different categories of cancer sera identified by the functional assay of NK regulation indicated differences among our group of patients which were not paralleled by differences in levels of cytotoxic reactivity of their NK cells assayed in vitro in the absence of autologous serum.(ABSTRACT TRUNCATED AT 400 WORDS)